Gut Check
Gut Check is a 8th season episode of House which first aired on April 9, 2012. The team treats a minor league hockey enforcer. Wilson finds out he has something in common with Thomas Bell. Park moves in with Chase. Recap After knocking another player to the ice with almost no effort in a hockey fight, a young hockey enforcer starts coughing up blood and collapses on ice. The lineman calls for a trainer. House is playing with a purloined table hockey game when the team comes in to discuss the case of the hockey player. Taub writes off the symptoms as the result of a punctured lung from a broken rib. House says the obvious - the emergency room ruled that out almost right away. As they discuss the differential, Taub and Chase argue about the role of fighting in hockey. House agrees to test for Chase’s idea of sarcoidosis and Adams’ idea of psittacosis. He once again dismisses Taub’s suggestion of a trauma to the esophagus by having him check the patient’s stool for blood. The patient is in a hurry because scouts from the NHL have been checking him out carefully, even though the only statistic he leads in is penalty minutes. The patient and Taub get into a discussion about the role of fighting in hockey. House goes to Wilson’s office to find him asleep. He turns on the lights to wake him up and guesses correctly that a neighbor’s baby has been crying all night and keeping him awake. House thinks that the crying is bringing out some sort of paternal instinct in Wilson and it’s not just the noise. They get into an argument about parenthood. All of a sudden House brings up an old girlfriend of Wilson’s Beth. House tells him that after they broke up, she called him while drunk and distraught to tell House to tell Wilson she was pregnant. House tells Wilson if he really wants a kid, he is the father of an 11 year-old. House reminds Wilson that, at the time, he asked him what he would think if Beth were pregnant and Wilson replied it would be the worst mistake of his life. Wilson thinks he is joking. House tells him it’s just as well he thinks that. While they give the patient a CT scan, Park is telling Chase how angry she is with her mother because she has to take care of her grandmother during her free time. Chase suggests she moves out. Park says that would be too disrespectful and Chase doesn’t understand because he’s so independent. Chase says he’s independent because he has no family any more. The scan rules out sarcoidosis, but shows an enlarged spleen. Taub once again dismisses the enlarged spleen as a clotting problem caused by repeated trauma. Park thinks it is leukemia. Chase suggests both an ultrasound to look for the clot and a white blood cell count to rule out leukemia and House agrees. Taub is taking the patient’s blood when he gets a call from his agent. Unfortunately, no NHL offer is coming. In addition, when Taub removes the patient’s top, he sees enlarged breasts. Wilson is outside on his balcony when House comes to see him again. Wilson has called Beth and confirmed what House told him. Wilson has a son. The patient’s enlarged breasts point to a hormone problem. The team is discussing a differential, but House sees the imprint of a seat belt on Park’s cheek and asks what’s up. She says she was in a fight with her mother. Taub guesses steroid abuse and House chides him on always jumping to the conclusion that it’s the patient’s profession that’s the root cause. To prove his point, House shows a video of the player that the patient beat up throwing the check that preceded the fight. Taub says that the hit was clean, but House has found out that the league reviewed the video and found the player’s hit was illegal and dangerous. House orders an environmental scan and tests for leptospirosis. Park and Chase do the environmental scan and discuss the fight with her mother. She says she can’t find any place she can afford. Chase offers up his spare bedroom. Park worries about the optics of the situation, but Chase assures her the room has a lock and says it must be better than her car. Park finds a prescription for ganciclovir in one of the player’s bags and thinks the patient may have caught mononucleosis. She also accepts Chase’s offer. As they shop at a toy store, House asks Wilson if he’s sure the kid is his. He shows House a picture - he’s the spitting image of Wilson. House tries to tell Wilson the kid must be screwed up. Wilson says he knows it might go badly, but he wants to meet the kid and the kid wants to meet him. Chase arrives home to find Park’s grandmother sitting on his couch. Park comes in and assures Chase she’s only there for an hour because her parents are at a medical clinic for a short procedure. Chase says the grandmother seems quiet, but Park says she’s often drunk. Taub comes to the patient room to find the patient crying and hiding on the floor next to his bed. Park thinks the crying is due to the patient’s hormone levels being out of whack. Adams points out that the patient is actually improving, but Taub is concerned about the crying even though it seems to be the only thing wrong with him now. However, Taub still thinks it’s due to his aggressiveness. House thinks the patient was crying because he knows he’s probably not going to make it in professional hockey. House then stares at Park and she blurts out that she is living with Chase and blames it on the fact they are drinking from identical coffee cups. She then blurts out that they’re not sleeping together. However, when House says “yet”, Park can’t stop talking and admits they may sleep together in future, but it’s impossible to tell right now. She gets back to the differential, but House starts asking Chase about his motives. He figures Chase is guilty for suggesting that Park leave home. House thinks the patient merely needs a psych consult which, if he passes, means they can discharge him. Wilson is at a diner when a young boy introduces himself. After a few awkward moments, Wilson presents him with a present - a video game system (He gives him a 'Gamedeck', a parody of the Nintendo DSi). However, his son already has one. He thanks Wilson anyway. The psych consult comes back fine. The patient apologizes and says he was probably down because of being in the hospital. He says he’s feeling much better. Taub tries to convince the patient to have an MRI, but the patient already knows the risks of concussion and says he doesn’t need any more tests. The son tells Wilson that his mother said he was nice, but had trouble forming relationships. However, the son always thought she was lying about him being nice because she didn’t want him to hate Wilson. He also knows that Wilson didn’t know about him until recently. The son admits he got his smarts from Wilson, but he’s a big soft-hearted wuss from his mother. Wilson says he’s a soft-hearted wuss too. The son has to leave, but he gets Wilson to agree to meet him that evening. Chase tells Taub he has gotten the patient to have an MRI by guaranteeing him it won’t show up on the chart. Taub comes in and points out an abnormality on the MRI, even though Chase says the scan is fine. Taub starts arguing, but he hears House’s voice over the intercom and, when the lights go on, it’s House in the MRI, not the patient. However, their pagers go off because the patient is having a stroke. They rush out and House realizes he’s stuck in the MRI. House performs a physical examination on the patient. He realizes the patient didn’t have a stroke, but one of his eyes is malfunctioning, which means that he’s still sick. Taub wants to discuss the matter out of earshot of the patient, but the patient asks to speak to House in private. When House comes out, Taub is sure that the patient wants him thrown off the case, but instead, the patient demanded that House apologize to Taub for the way House treated him. Chase suggests microscopic polyangiitis. The treatment is plasmapheresis. Chase wants to confirm because of the risk of bleeding, but Taub says that it could progress quickly. House agrees with Taub and starts treatment. Wilson tells House that his son is polite and intelligent. House says that means the son doesn’t need Wilson. Wilson says he’s having his son over for dinner. Wilson accuses House of being jealous. Wilson and his son make pizzas. Wilson wants to know more about him, but his son has nothing more to say. It’s clear that the son wants more toppings, and asks if Wilson has prosciutto and goat cheese. Wilson loves them too and goes to get some from his refrigerator. He drives his son home while they discuss how good the pizzas were. The son explains his mother is estranged from her family. Wilson says his parents will probably be excited to meet him. As they get to the son’s house, he reaches over, hugs him, and says he loves him. As they do the plasmapheresis, Taub asks the patient if he likes what he does. Taub tells the patient he used to make a lot of money doing plastic surgery, but he was miserable doing it. The patient tells Taub he started out as an outstanding scorer, but as he got older, he stopped getting more talented and his coach told him his size would be the only thing that would keep him playing hockey. Eventually, the only time he got on the ice was to fight. All of a sudden, the patient complains he can’t feel his arms. The patient now has paralysis in his arms and microscopic polyangiitis has been ruled out by tests. House wants to focus not only why Chase is letting Park stay over, but why he’s spending time with her grandmother too. He thinks Chase is guilty about all the women he’s slept with. Taub thinks the patient caught botulism from an injection his trainer gave him to treat a muscle spasm. Taub wants to confirm first because of the risk of anaphylactic shock from the treatment. but House accuses him of being too involved with the patient now and orders the anti-toxin. Luckily, the anti-toxin has no adverse effects. Park comes in to see Taub and starts complaining about Chase. The whole point of Park moving out was to get away from her grandmother, but now her grandmother is always over at Chase’s apartment and Chase is getting along well with her. Taub suggests if it’s not about guilt over having Park move out or guilt over being a Casanova, Chase is probably trying to sleep with Park. Park wonders why that’s such a big deal - good looking guys often want to sleep with her. Taub wonders if they are as good looking as Chase. All of a sudden, Taub sees the patient’s finger move and wakes him up. Wilson tells House he’s not going to get mad at him for not telling him about his son earlier, and thanks him instead for not making him wait longer. House reminds him that he’s Wilson’s longest relationship. Wilson says a needy narcissist is perfect training for raising a young boy. House says a son is a much bigger responsibility - much bigger than anything Wilson has taken on. Wilson says he knows, but that’s why he’s looking forward to it. Taub is playing table hockey with the patient, who is incredulous that Taub prefers being with sick patients rather than doing breast enlargement surgery. The patient admits he feels safe when he‘s in the penalty box, and that the players he protects can never feel safe. Taub scores, but as he’s celebrating, the patient starts being tachycardic and his breathing becomes rapid. Taub calls for help. The patient is now completely paralyzed, and his test for botulism was negative. Taub shoots down all the suggestions. House then tells Taub he lied and the patient did ask that he be taken off the case. He then orders a brain biopsy to test for prion diseases over Taub’s objections. Wilson’s son arrives at the diner and tells him that his mother is flying to Costa Rica to open up a reserve for birds of prey. The son asks if he could stay with Wilson. Wilson says he needs time to think about it, but the son asks him not to send him to the jungle. He says he will take him in if his mother is okay with it. He gets another hug. Taub asks House to take him off the case. House agrees, but asks why he should not take him off all the cases because he’s a bully too. Taub says House isn’t a bully, but House disagrees. Taub says bullies mock for self-aggrandizement, but House does it because ideas are more important than feelings. However, when House presses him on the matter, Taub thinks of something. Taub rushes to the operating room to call off the biopsy. The Epstein-Barr virus that gave the patient mononucleosis also gave him Miller Fisher syndrome. House’s metaphor about “playing through the whistle” made him realize that the plasmapheresis was actually treating it, but since they thought it was microscopic polyangiitis and that had been ruled out, they stopped the treatment. The plasmapheresis continued to make him feel better even though they discontinued it, and they thought it was the anti-toxin. Paralysis is a common symptom of Miller Fisher and, when they stopped plasmapheresis, it reasserted itself. House agrees and orders the plasmapheresis restarted. Wilson tells House how he agreed to let his son move in with him. Wilson realizes that neither he nor his son are ready for that. He admits House was right. House opens the door and Wilson’s son is outside. However, House admits it was all a set up - the kid is an actor. The son says it was all House’s idea and if Wilson wants to be mad, he should be mad at House. Wilson throws them out. The patient is improving and he has just agreed to a three year $2.1 million contract. He says half a dream is better than nothing. Park is alone in the elevator with Chase. She says she won’t sleep with him. Chase acts disappointed. However, Park realizes Chase wants to spend time with her grandmother because he has no family of his own. Park says she might change her mind about sleeping with him. Park’s grandmother and Chase are playing cribbage. Park goes home to her mother. Wilson asks about Beth. House says he found her on Facebook and she agreed to go along with the deception because she’s still mad at Wilson. Major Events *House tells Wilson that Wilson has a son from a previous relationship, but when the boy shows up, House eventually admits he’s an actor he hired. *Park moves out of her parent’s house and moves in with Chase. However, she returns to her parents, only to have Chase start a friendly relationship with her grandmother Popo. Zebra Factor 7/10 Miller Fisher is very rare. Only about 1 in 2,000,000 people get it in any given year. However, the Epstein-Barr virus that causes mononucleosis is one of the most common causes of Miller Fisher and it’s associated condition Guillain-Barre syndrome. The team probably should have seen the connection sooner given the patient’s medical history. Trivia & Cultural References *The title refers to a metaphor about gauging one’s courage before taking a major life change. A “check” in hockey is a move to separate a player from the puck. *More about Ice Hockey *Trenton’s hockey team isn’t the “Toros” but the Titans, which play in the East Coast Hockey League. *The “Habs” are the Montreal Canadiens (from their nickname “Les Habitants”, the French nickname for the original French settlers of Quebec) and the “Bruins” are the Boston Bruins *More about Fighting in hockey *Planned Parenthood is an international organization that deals with issues of reproductive health, including contraception. *“Booby Orr” is a play on the name Bobby Orr, a legendary defenceman for the Boston Bruins and Chicago Black Hawks. *Sand art is the use of colored sand or crystals to make either permanent or transient works of art. *The reference to the “Kennedys having a lovely trip to Dallas” is a reference to the Assassination of John F. Kennedy in Dallas in 1963. *Uncle Jesse and the Olsen Twins are a reference to the television series Full House *The Butterfly effect refers to one of two ideas in Chaos Theory. In this episode, it’s the idea that the beating of a butterfly’s wings will affect weather weeks later. *Quinoa pronounced (keen-wa) is a type of edible seed. *Prosciutto is a type of ham made by curing it in cool, dry air. It is usually served uncooked and thinly sliced. *Goat cheese is, of course, made from the milk of goats, not goats themselves. *Dijon is a type of mustard made exclusively from seeds grown in and around Dijon, France. *The “Pocket Rocket” was the nickname of Henri Richard, the much younger brother of hockey legend Maurice “The Rocket” Richard. However, the younger Richard brother distinguished himself by playing on a record eleven Stanley Cup winning teams, three more than his older brother or anyone else. *Costa Rica is a country in Central America *Days of our Lives is a long running soap opera. *Omar Epps does not appear in this episode. Taub mentions Foreman, however. Cast *Hugh Laurie as Gregory House *Omar Epps as Eric Foreman *Robert Sean Leonard as James Wilson *Jesse Spencer as Robert Chase *Peter Jacobson as Chris Taub *Odette Annable as Jessica Adams *Charlyne Yi as Chi Park *Greg Finley as Bobby Hatcher *Will Shadley as Duncan *Saachiko as Popo *Stephanie Whitfield as Waitress *Christian Lalonde as Szabo *Joseph Patrick Kelly as Lineman *Bobbin Bergstrom as Nurse *William Mulligan as Crazy Hockey Fan Category:Episodes Category:Season 8